• Title/Summary/Keyword: Rank regression

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Prognostic Factors Influencing the Result of Postoperative Radiotherapy in Endometrial Carcinoma (자궁내막암의 수술 후 방사선치료 결과에 영향을 미치는 예후인자)

  • Ki Yong-Kan;Kwon Byung-Hyun;Kim Won-Taek;Nam Ji-Ho;Yun Man-Su;Lee Hyung-Sik;Kim Dong-Won
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.110-115
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    • 2006
  • Purpose: This study was performed to determine the prognostic factors influencing relapse pattern, overall and disease-free survival in patients treated with postoperative radiotherapy for endometrial carcinoma. Materials and Methods: The records of 54 patients with endometrial adenocarcinoma treated postoperative radiotherapy at Pusan National University Hospital between April 1992 and May 2003 were reviewed retrospectively. Median age of the patients was 55 (range $35{\sim}76$). The distribution by surgical FIGO stages were 63.0% for 0Stage I, 14.8% for Stage II, 22.2% for Stage III. All patients received postoperative external radiotherapy up to $41.4{\sim}54Gy$ (median: 50.4 Gy). Additional Intravaginal brachytherapy was app led to 20 patients (37.0% of all). Median follow-up time was 35 months ($5{\sim}115$ months). Significant factors of this study: histologic grade, Iymphovascular space invasion and myometrial invasion depth were scored (GLM score) and analyzed. Survival analysis was peformed using Kaplan-Meier method. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. Results: 5-year overall and disease-free survival rates were 87.7% and 871%, respectively. Prognostic factors related with overall and disease-free survival were histologic grade, Iymphovascular space invasion and myometrial invasion according to the univariate analysis. According to the multivariate analysis, Iymphovascular space invasion was associated with decreased disease-free survival. GLM score was a meaningful factor affecting overall and disease-free survival (p=0.0090, p=0.0073, respectively) and distant recurrence (p=0.0132), which was the sum of points of histologic grade, Iymphovascular space Invasion and myometrial invasion. Total failure rate was 11% with 6 patients. Relapse sites were 2 para-aortic Iymph nodes, 2 lungs, a supraclavicular Iymph node and a vagina. Conclusion: The prognosos in patients with endometrial carcinoma treated by postoperative radiotherapy was closely related with surgical histopathology. If further explorations confirm the system of prognostic factors in endometrial carcinoma, it will help us to predict the progression pattern and to manage.

A study for the factors on choosing hospitals and patients satisfaction between Geriatric Hospitals and General Hospitals (노인병원과 종합병원의 선택요인 및 환자만족도 분석)

  • Yoon, Seo-Jung;Yu, Seung-Hum;Kim, Young-Hoon;Lee, Ji-Jeon
    • Korea Journal of Hospital Management
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    • v.9 no.2
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    • pp.46-75
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    • 2004
  • This research anticipated on acknowledging the inpatients factors in choosing which hospital for the geriatric hospital and general hospital they would prefer to go to the analization of different factors in patients satisfaction, and the relation between satisfactory standards and the patients intentions on recommendation or re-visiting the hospital. The statistical data was based upon the 359 question and answer papers that were done by inpatients that were hospitalized in two geriatric hospitals and two general hospitals, and the methods used for analyzing were frequency, t-test, factor analysis, and hierarchical multiple regression. The results are as follows. 1. The factors on choosing hospitals between geriatric hospital and general hospitals were different. The priority for the geriatrics was kindness, and then considerate nursing, and the reliance of treatment. The patients of general hospitals looked first for reliance of treatment, reputation and history of the hospital, and the kindness of the staff. The kindness of the staff, good nursing, and easy procedures were the primary factors of choosing geriatric hospital. 2. The four primary factors in choosing which hospital patients would go to were the predominance of the facilities, kindness and convenience, the reliance and proximity of medical treatment, and recommendation. The patients in the geriatric hospital first looked for kindness and convenience, second the reliance and proximity of medical treatment, third predominance of facilities, and last recommendation. The general hospitals main priority was the reliance and proximity of medical care, second predominance of facilities, kindness and hospitality, and last recommendation. 3. The satisfaction rate was higher in the geriatric hospital compared to general hospitals, but the satisfactory of factors were very similar. Patients in the geriatric hospital were pleased with the hospital staffs kindness, quick nursing and the improvement of inconvenient matters, and clear diagnosis of the doctors. The general hospital patients were satisfied with the hospital staffs clear explanation and accurate diagnosis 4. The analysis in the satisfactory factors turned out to be the environment of the hospital, kindness of the staff, and convenience. Both the patients of the geriatric hospital and general hospitals were very pleased with the kindness of the hospital staff. Ranking second and third was convenience and service for the geriatric hospital, and environment of the hospital and convenience for the general hospital. 5. According to a rank of multiple recurrent analysis of the patients satisfaction and the intention of re-visiting in addition to intention of solicitation, in the case of a geriatric hospital, when the intention of re-visiting is the dependent variable, the first stage shows that the less insurance the patient has, the higher was the intention of re-visiting. In the second stage, the more satisfied the patient is of the staffs kindness, the higher was the intention of re-visiting. Further more, when the intention of solicitation is the dependent variable, the first stage shows that not all the independent variables were significant, but the second stage shows that the more satisfied the patient is of the staffs kindness and the hospital along with the medical treatment expenses, the higher was the intention of solicitation. 6. In the first stage of a rank of multiple recurrent analysis of the satisfaction of the general hospital and the intention of re-visiting, not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. Moreover, when the intention of solicitation was the dependent variable, the first stage shows not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. That is to say, in the case of a general hospital, the satisfaction of the hospital and the medical treatment expenses were high, and the more satisfied the patient is of the hospitals environment and the staffs kindness, the intention of re-visiting and the intention of solicitation was higher.

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A Study on the Financial Strength of Households on House Investment Demand (가계 재무건전성이 주택투자수요에 미치는 영향에 관한 연구)

  • Rho, Sang-Youn;Yoon, Bo-Hyun;Choi, Young-Min
    • Journal of Distribution Science
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    • v.12 no.4
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    • pp.31-39
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    • 2014
  • Purpose - This study investigates the following two issues. First, we attempt to find the important determinants of housing investment and to identify their significance rank using survey panel data. Recently, the expansion of global uncertainty in the real estate market has directly and indirectly influenced the Korean housing market; households demonstrate a sensitive reaction to changes in that market. Therefore, this study aims to draw conclusions from understanding how the impact of financial strength of the household is related to house investment. Second, we attempt to verify the effectiveness of diverse indices of financial strength such as DTI, LTV, and PIR as measures to monitor the housing market. In the continuous housing market recession after the global crisis, the government places top priority on residence stability. However, the government still imposes forceful restraints on indices of financial strength. We believe this study verifies the utility of these regulations when used in the housing market. Research design, data, and methodology - The data source for this study is the "National Survey of Tax and Benefit" from 2007 (1st) to 2011 (5th) by the Korea Institute of Public Finance. Based on this survey data, we use panel data of 3,838 households that have been surveyed continuously for 5 years. We sort the base variables according to relevance of house investment criteria using the decision tree model (DTM), which is the standard decision-making model for data-mining techniques. The DTM method is known as a powerful methodology to identify contributory variables for predictive power. In addition, we analyze how important explanatory variables and the financial strength index of households affect housing investment with the binary logistic multi-regressive model. Based on the analyses, we conclude that the financial strength index has a significant role in house investment demand. Results - The results of this research are as follows: 1) The determinants of housing investment are age, consumption expenditures, income, total assets, rent deposit, housing price, habits satisfaction, housing scale, number of household members, and debt related to housing. 2) The impact power of these determinants has changed more or less annually due to economic situations and housing market conditions. The level of consumption expenditure and income are the main determinants before 2009; however, the determinants of housing investment changed to indices of the financial strength of households, i.e., DTI, LTV, and PIR, after 2009. 3) Most of all, since 2009, housing loans has been a more important variable than the level of consumption in making housing market decisions. Conclusions - The results of this research show that sound financing of households has a stronger effect on housing investment than reduced consumption expenditures. At the same time, the key indices that must be monitored by the government under economic emergency conditions differ from those requiring monitoring under normal market conditions; therefore, political indices to encourage and promote the housing market must be divided based on market conditions.

Comparision of Group and Individual Social Support on Burden and Family Functioning in Families with Asthmatic Children (집단 사회적지지와 개별 사회적지지가 천식아동 가족의 부담감과 가족기능에 미치는 영향)

  • 전화연
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.418-428
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    • 1999
  • The main purpose of this study was to identify the effects of group social support and individual social support on the reduction of burden and improvement in family functioning of families with asthmatic children. The design of this study was a randomized pre-posttest quasi-experimental design to compare the two experimental groups. The theoretical framework for this study was derived from the study of burden in family caregivers by Suh and Oh (1993) based on the main effect model of social support theories. The data were collected from February 12, 1998 to May 29, 1998 at the pediatric out patient department of a university hospital located in Suwon city. The sample consisted of 39 family members who were identified as families with asthmatic children, Eighteen subjects were randomly assigned to the group social support group and 21 were assigned to the individual social support group. Group and individual social support members were seen for 60 to 90 minutes, four times over one to three weeks. The instruments used in this study were the Burden Scale developed by Suh & Oh(1993), the Visual Analogue Scale, and the Family Adaptability Cohesion Evaluation Scale(FACES-III) developed by Olson, Portner, and Lavee(1985). The collected data were analyzed using Mann-Whitney test, x$^2$-test, Wilcoxon sign rank test, t-test, ANOVA (Scheff), Pearson correlation coefficient. multiple regression, and social support process and content analysis. The results are as follow : 1. There was no significant difference before the experimental treatment among the subjects in the group social support group and individual social support group for general characteristics, burden, or family functioning. 2. Hypothesis 1 : “There will be a greater reduction on the burden score of the group social support group compared to the individual social support group” was not statistically significant(U=174.5, p=.683). The burden scores showed a significant decrease after participation in social support as compared to before participation for both groups. However there was a tendency for more reduction in the burden scores for the group social support than for individual social support. 3. Hypothesis 2 : “There will be a greater improvement in the family functioning scores for the group social support group compared to the individual social support group” was not statistically significant(U=153.0. p=.309). There was a tendency toward improvement in the family functioning scores of the group social support as compared to that of the individual social support. 4. According to the length of the treatment period, families with asthmatic children displayed affirmative responses, and the families set up a self-help group of mothers with asthmatic children in order to share their experiences, to get information and to solve their problems. In conclusion, it was found that group social support was the more effective nursing intervention for reducing burden and for improving family functioning of families with asthmatic children.

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Hypoalbuminemia as a Predictor of 30-day Mortality in Patients with Acute Organophosphate Insecticide Poisoning (유기인계 살충제 중독환자에서 30일 사망률에 대한 예후 예측인자로서의 저알부민혈증의 유용성)

  • Kim, So Yeon;Lee, Ryun Kyung;Kim, Tae hu;Kim, Dong Hoon;Kim, Taeyun;Lee, Soo Hoon;Jeong, Jin Hee;Lee, Sang Bong;Kang, Changwoo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.1
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    • pp.11-16
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    • 2017
  • Purpose: The association of hypoalbuminemia with 30-day in-hospital mortality in patients with organophosphate insecticide poisoning (OPI) was studied. Methods: This retrospective cohort study was conducted between January 2006 and November 2013 in the emergency department (ED) after OPI poisoning. A Kaplan-Meier 30-day survival curve and the log-rank test were used to analyze patients stratified according to serum albumin levels on ED admission (hypoalbuminemia or normo-albuminemia). Independent risk factors including hypoalbuminemia for 30-day mortality were determined by multivariate Cox regression analysis. Results: A total of 135 patients were included. Eighty-eight (65%) patients were male and the mean age was $57.3{\pm}17.0$ years. Serum albumin, mean arterial pressure, and Glasgow coma scale score were significantly higher in the survival group than the non-survival group. APACHE II score was significantly lower in the non-survival group than the survival group. The mortality of the hypoalbuminemia group (serum albumin <3.5 g/dl) was 68.8%, while that of the normo-albuminemia group (serum albumin ${\geq}3.5g/dl$) was 15.1%. The area under the ROC curve of the serum albumin level was 0.786 (95% CI, 0.690-0.881) and the APACHE II score was 0.840 (95% CI, 0.770-0.910). Conclusion: Hypoalbuminemia is associated with 30-day mortality in patients with OPI poisoning.

The Investigation of Risk Factors Impacting Breast Cancer in Guilan Province

  • Joukar, Farahnaz;Ahmadnia, Zahra;Atrkar-Roushan, Zahra;Hasavari, Farideh;Rahimi, Abbas
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4623-4629
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    • 2016
  • Introduction: Breast cancer is multifactorial therefore more recognition of risk factors is important in its prevention. Objective: This study was conducted in order to determine the factors influencing breast cancer in women referred to health centers in Guilan province in 2015-2016. Method: In a case- control study, 225 women with breast cancer were investigated. The control group consisted of 225 healthy women of the relatives (third-rank) whose phone numbers were obtained from the patients. Data were collected through telephone interviews. Results: The risk of breast cancer raised in women who have a family history of other cancers (OR= 3.5; 95% CI= 1.96-6.6), exposure to X-Ray (OR= 2.5; 95% CI=1.1-5.5), having more than 4 children (OR= 2.695% CI=1.2-4.8), age more than 36 years at first pregnancy(OR=2.3; 95% CI=0.7-5.1),primary levelof education (OR= 5.4;95% CI=2.8-11.2) and inadequate intake of fruit (OR=1.5; 95% CI=1-2.2). Also, presence of the following factors reduced breast cancer risk: regular menstruation (OR= 0.66; CI=0.4-0.9), duration of breastfeeding more than 12 months, less than 6 months and 7-12 months (OR=0.23; 95% CI=0.09-0.59, OR=0.29; 95% CI=0.17-0.49 and OR=0.03; 95% CI=0.01-0.08) and parity (OR=0.4; 95% CI=0.27-0.83) In multiple linear regression analysis of higher education (OR=0.16; 95% CI=0.03-0.77), using contraceptives for more than 16 years (OR=2.3; 95% CI=1.4-3.9), family history of other cancers (OR=6.1; 95% CI=1.9-19.3) and a history of X-Ray exposure (OR=4.4; 95% CI=1.07-18.1) were considered as predictive factors. Conclusion: The results of this study emphasize the importance of informing women about breast cancer risk factors. So, identification of these risk factors is required as important means of prevention and treatment of breast cancer.

The Effect of Recovery Justice according to the Types of Service Failure on the Quality of a Customer-Brand Relationship (서비스 실패 유형에 따른 회복 공정성이 고객-브랜드 관계의 질에 미치는 영향)

  • Kim, Ki-Young;Park, Kyong-Tae;Baek, Jong-On
    • Culinary science and hospitality research
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    • v.15 no.4
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    • pp.273-285
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    • 2009
  • In order to find how the recovery justice from the service procedure and result failure affects the quality of customer-brand relationship, we conducted this study following pre research, its correction and supplement of the customers who experienced some service failures in food restaurant. We selected the best five brands in Korean food franchise in the rank of the sales on basis of data of Korean Food Restaurant Information in year 2009. The participants of this research were the people who live in Seoul metropolitan area and ever experienced any service failure within recent 6 months. Of the 500 copies of survey questionnaires distributed, 391 were used for the analysis. The method used for this analysis was the SPSS for WIN 12.0 program and the analysis such as technical statistics analysis, reliability analysis, research element analysis and regression analysis were applied. As a result, the service shortage factor which is one of the service process failures was confirmed to affect procedural justice and distributive justice. It has been confirmed that procedural justice and distributive justice are influenced by the hygiene deficiency which is one of the result failures. It was also found that the product factor affects distribution justice. As for the effect of the quality of recovery justice and a customer-brand relationship, procedural justice and distributive justice were found to affect the mutual dependency while procedural justice affects a familiarity.

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The Difference in Attitude toward Medical Care between Patients and Physicians (환자와 의사의 의료에 대한 태도 차이 -한 중소도시의 대학병원과 한의과대학 부속 한방병원을 중심으로-)

  • Kang, Myung-Guen;Park, Jong-Ku;Kim, Han-Joong;Sohn, Myong-Sei;Kim, Dal-Rae
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.516-539
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    • 1998
  • The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

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Prognostic analysis of uterine cervical cancer treated with postoperative radiotherapy: importance of positive or close parametrial resection margin

  • Kim, Yi-Jun;Lee, Kyung-Ja;Park, Kyung Ran;Kim, Jiyoung;Jung, Wonguen;Lee, Rena;Kim, Seung Cheol;Moon, Hye Sung;Ju, Woong;Kim, Yun Hwan;Lee, Jihae
    • Radiation Oncology Journal
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    • v.33 no.2
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    • pp.109-116
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    • 2015
  • Purpose: To analyze prognostic factors for locoregional recurrence (LRR), distant metastasis (DM), and overall survival (OS) in cervical cancer patients who underwent radical hysterectomy followed by postoperative radiotherapy (PORT) in a single institute. Materials and Methods: Clinicopathologic data of 135 patients with clinical stage IA2 to IIA2 cervical cancer treated with PORT from 2001 to 2012 were reviewed, retrospectively. Postoperative parametrial resection margin (PRM) and vaginal resection margin (VRM) were investigated separately. The median treatment dosage of external beam radiotherapy (EBRT) to the whole pelvis was 50.4 Gy in 1.8 Gy/fraction. High-dose-rate vaginal brachytherapy after EBRT was given to patients with positive or close VRMs. Concurrent platinum-based chemoradiotherapy (CCRT) was administered to 73 patients with positive resection margin, lymph node (LN) metastasis, or direct extension of parametrium. Kaplan-Meier method and log-rank test were used for analyzing LRR, DM, and OS; Cox regression was applied to analyze prognostic factors. Results: The 5-year disease-free survival was 79% and 5-year OS was 91%. In univariate analysis, positive or close PRM, LN metastasis, direct extension of parametrium, lymphovascular invasion, histology of adenocarcinoma, and chemotherapy were related with more DM and poor OS. In multivariate analysis, PRM and LN metastasis remained independent prognostic factors for OS. Conclusion: PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study. Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT. Therefore, additional treatments to improve local control such as radiation boosting need to be considered.

A Study on the Family Problem of the Hospitalized Patients (입원환자가족의 가정문제에 관한 연구)

  • Hwang Youngbin
    • Journal of Korean Public Health Nursing
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    • v.4 no.2
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    • pp.79-99
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    • 1990
  • This study was conducted to identify the family problems of the in-patients and to analize factors Influencing to the family problems. The subjects for this study were 277 family members those who were giving care for the adult patients during hospitalized in general wards at Seoul National University Hospital in Seoul. Data were collected through interviews with the questionnaire from September second to September twentieth in 1989. The instrument used for this study was the family problems scale which was developed by the researcher. Analysis of data was done by frequency, percent, mean, t-test, ANOVA, Pearson-Correlation Coefficients, and Stepwise Multiple Regression Analysis. The results of this study are summarized as follows: 1. General characteristics of the care-giver in family. The average age of care-givers was 37.9 years, and the $26.4\%$ of monthly Income of family was 310,000-500,000 won group. The $93.5\%$ of family had taken the responsibility of caring for the patients instead of hiring the care-givers, and the $12.3\%$of the care-givers complained weakning of health status during care giving for the patients. The spouse took the largest part of responsibility of the care-giving services to the patient among the family members. 2. General characteristics of the patients. The average age of patient was 47 years, and the $80.9\%$ of patient was married status. The $39\%$ of patient was father in the position of family, and the $41.5\%$ had the responsibility to support their family before hospitalization. The average hospitalization period of patient was 24.3 day and the $50.9\%$ had admission experience. 3. The factors of family problems which were faced by the family were classified into six problems. The factors of family problems were ranked as follows; the first rank problem was related to care-giving for the patients. the second problem was resulted from the patients diseases, the theirds problem was related with adaptation to the hospital enviroments, the fourth problem was related to the arisen conflicts with medical team. the fifth problem was related to the change of family function. and the sixth problem was the financial problem. 4. The relationship between the family problems and the general charateristics of the care-givers showed that the nuclear type family was higher the family problems, that the admission period of patients became longer, and that the family who had the worse condition of health status of the care givers during care giving for the patients. From the above results, it was confirmed that the family care giving for patients was faced with some problems resulted from patient's illness, relation to the medical team, adaptation to the hospital enviroment, financial problem. change of family function, and care-giving for patients.

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